Child refugees dying needlessly due to vaccine bureaucracy - MSF

Refugee children copy notes from a chalkboard during an open-air English lesson from a volunteer refugee teacher under a tree at Yida camp in South Sudan's Unity State, April 20, 2013. REUTERS/Andreea Campeanu

MSF says new vaccine could have saved many children's lives in South Sudan refugee camps but bureaucracy and red tape stopped it reaching them in time

NAIROBI (Thomson Reuters Foundation) – Many children living in South Sudanese refugee camps have died needlessly because of bureaucratic delays rolling out new vaccines, the medical charity Medecins Sans Frontieres (MSF) said on Thursday.

MSF said it had taken 11 months to procure affordable drugs to vaccinate children against pneumonia in Yida refugee camp in South Sudan due to bureaucratic and legal red tape.

It said it had obtained the vaccine from pharmaceutical firm GlaxoSmithKline to start vaccinating children in Yida camp and this should lead to a substantial cut in the number of deaths.

Sudanese refugees began streaming across the border into South Sudan in June 2011, fleeing conflict between the Khartoum government and rebels in South Kordofan.

Large numbers of children died in MSF’s hospital in the camp last year. Respiratory tract infections, such as pneumonia, were one of the main causes of death.

“The situation in Yida last year was excruciating, with children dying of diseases that vaccines could have protected them against,” Audrey Landmann, MSF project coordinator in Yida at the time, said in a statement.

Children in refugee camps are highly vulnerable to disease as they are often malnourished and living in overcrowded conditions with inadequate shelter, clean water or sanitation facilities.

The pneumococcal vaccine is a new vaccine, first introduced by the Global Alliance for Vaccines and Immunisation (GAVI Alliance) to Kenya in 2011. Pneumococcal disease, which can cause pneumonia, meningitis and sepsis, kills more than half a million people a year, half of them children under five.

BLIND SPOT

GAVI, set up in 2000, uses private and government donor backing to negotiate down vaccine prices for the developing world and then bulk-buy and deliver them to some of the world’s poorest countries.

It has made major strides in rolling out new vaccines in poor countries at affordable prices - but it does not cover vaccination in refugee and crisis-affected populations.

Pharmaceutical companies like Pfizer and GSK sell their new vaccines to GAVI at a discount but do not offer the same prices to medical charities like MSF.

MSF paid GSK $7 per dose for the vaccine, compared with the $3.40 a dose GAVI pays as a result of signing a 10-year deal with Pfizer and GSK to buy millions of doses of their patented pneumonia vaccine.

Three doses are needed per child.

“Why do we keep hearing the players in the global vaccination community tell us these kids aren’t their problem?” said Kate Elder, Vaccines Policy Advisor at MSF’s Access Campaign.

“We should be making every effort for refugee children to benefit from the newest vaccines, instead of letting them languish in the global community’s blind spot.”

FRUSTRATED

At the heart of the dispute is a difference in philosophy between GAVI’s development-oriented approach and MSF’s humanitarian creed.

GAVI is focused on building up governmental vaccination programmes. It funds and supports governments to develop the health systems, staff and expertise needed to immunise their children over the long term.

The governments also pay a percentage of the price of the vaccines with a view to taking on the cost themselves in future.

“The whole idea is to build up their immunisation system so that they can eventually do it themselves,” said a GAVI spokesman. “We don’t just parachute in when we feel like it and start immunising kids.”

In contrast, MSF works in some of the world’s toughest humanitarian disaster zones where there is often no government presence at all.

In South Sudan, the fledgling two-year-old government is not yet providing the pneumococcal vaccine to its own children.

In April, MSF launched a ‘Dear GAVI’ campaign on the issue of accessing low-cost vaccines for refugees and crisis-affected populations.

It said it had been “frustrated by bilateral discussions, which have been ongoing for a few years now” and that it anticipated that it “will also be a challenge” to obtain other new vaccines, like rotavirus, at the prices GAVI pays.

MSF said it was looking for a sustainable solution to the problem so that it could act swiftly in future crises.

The GAVI spokesman said GAVI did allow non-governmental organisations to deliver vaccines in some countries, such as Afghanistan, where the state is weak or does not control the entire country.

“We are discussing some flexibility on how we support fragile states,” he said.